Healthcare Provider Details

I. General information

NPI: 1841677622
Provider Name (Legal Business Name): THERESA J. ASHLEY APN, NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2015
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 EVERETT DR FL 7 STE 3200
OKLAHOMA CITY OK
73104-5047
US

IV. Provider business mailing address

190 CEDAR BROOK PL
FARMINGTON AR
72730-8810
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-5215
  • Fax: 405-271-1236
Mailing address:
  • Phone: 901-493-4169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number221859
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number2016039183
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberA004436
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: